David Cullinane (Sinn Fein) | Oireachtas source

I welcome the Minister to the House. It is good we are discussing an EU directive. It is good practice and we should do more of it. I welcome the directive and the rules which govern cross-border health care in the EU. Such rules are particularly important when one considers the high level of mobility between countries generally, but obviously it is much more prevalent, and I suppose much more useful and relevant to this State, with regard to mobility of patients either side of the Border.

In this context, the rules as set out in the directive will hopefully enable access to safe and high quality cross-border health care in the EU. We also welcome that member states are obliged under the directive to ensure patients have access to and receive on request relevant information on safety and quality standards in other member states.

I worked quite a lot with a number of patient groups which are campaigning for better safety standards in regard to hospital acquired infections, and I am sure the Minister has been in contact with many of these campaigning groups. I have attended many seminars across the State, including a number in the south east in recent years where people spoke about the Dutch model and the different approaches and systems in place in different countries. Patients from other countries who had been victims of hospital-acquired infection or who benefited from the better protections they have in those countries spoke at some of the conferences and seminars. This kind of directive gives patients and patient groups the opportunity to get the information on what is best practice and what is happening across the EU.

The ruling also has the potential to facilitate uniformity of practice and to lead to ongoing improvements in standards. While patients, advocate groups and patient groups can obviously benefit from this directive, states and departments can also learn about best practice and uniformity in regard to health care settings. It could also be productive in terms of the sharing of advances in international medical science, in the dissemination of advances in good practice and in the diffusion of innovations in health technologies. Ireland is in a very good position in regard to health care technology. In my own city of Waterford, the TSSG is now working on innovation and new technologies in health care, looking at the different innovation models that can be used and working towards international best practice.

At a more basic level, the fact the directive clarifies issues concerning reimbursement is also to be welcomed. At a broader level, it is interesting to note the directive states that health systems are a central component of the EU's high levels of social protection and that the values of universality, access to good quality care, equity and solidarity are cornerstones of the EU project, which they are. While all of those are very laudable objectives, however, I imagine that even the Minister would admit we have some way to go to get to a fully universal system here in this State, and we still have some bottlenecks in the system where patients are waiting far too long to be treated.

I take the opportunity to again remind the Minister that, as I am sure he is aware, there is not a day my constituency office does not get a telephone call from some patient waiting for orthopaedic treatment at Waterford Regional Hospital. It happens every day of the week and is a big problem. I offer this as one example that we have a long way to go to get to the type of good quality care, equity and solidarity the directive suggests should underpin health care. For me, that is exactly what the EU should be about. It should be about driving social change, improving systems and working together, where we can, to make sure we have best practice and that we can learn from each other. It is about building a social Europe, and I am very supportive of that model. However, it sometimes rings hollow when we look at how it is practised and what people actually get in reality here in this State. We only have to look at the recent recession and look at the money which is being taken out of health care. We are looking towards a budget where more money will potentially be taken out of the health care system and the impact that will have.

Since 2011, under the current Government, the amount of health care spending accounted for by the public sector has declined. It is interesting to note that the OECD's report and commentary attributes reductions in Irish public spending on health to, first, cuts in wages, second, reductions in the number of health workers and, third, the fact investment in the public health service has been put on hold. I believe that is a very honest reflection of the position of the health service. Investment has been put on hold or cut back and wages have been cut back, which has impacted on the morale of staff and the provision of services. When we raise these issues, the Minister always says it is not just about how much we put into the system but about what we get out the other end, and there is some logic to what he says. However, he cannot with all seriousness say that taking out all of this money does not have any impact on patient care, because it does.

We support the directive and we are pleased to have the opportunity to put that on the record of the Seanad.